Case Report: Multiple Tuberculous Tenosynovitis of the Flexor Tendons of the Wrist and Hand

Case Report: Multiple Tuberculous Tenosynovitis of the Flexor Tendons of the Wrist and Hand

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Author(s)

Author(s): Jinjun Liang, Dan Yang, Xuhao Yang, Yunjun Wu, Guo Fu

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DOI: 10.18483/ijSci.2438 20 58 33-37 Volume 10 - Apr 2021

Abstract

Background: Tuberculosis is a significant public health challenge and tuberculous tenosynovitis is therefore a rare form of musculoskeletal tuberculosis which usually affects the flexor tendons of the hand and wrist. Case presentation: We present a case of a 63-year-old male. He presented multiple progressively enlarging mass over the volar side of the right hand and wrist. He did not have a previous history of tuberculosis. However, his erythrocyte sedimentation rate was high and tuberculosis antibody test was slightly positive. Radiograph of chest showing multiple nodular and patchy dense shadows in bilateral lungs, and localized soft tissue mass around the radiocarpal joint. Excision biopsy of the mass was done and samples sent for histopathology comment. The findings were an inflamed, thickened synovia: suggestive of tuberculous tenosynovitis. Anti-tuberculous chemotherapy was commenced on the second postoperative day. Conclusion: Tuberculous tenosynovitis of the wrist is rare. However, in developing area where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment.

Keywords

Tenosynovitis, Wrist, Hand, Flexor Tendons, Mycobacterium Tuberculosis, Tuberculosis

References

  1. Aboudola S, Sienko A, Carey RB, Johnson S. Tuberculous tenosynovitis. Hum Pathol (2004) 35(8):1044-6. doi: 10.1016/j.humpath.2004.04.005. PubMed PMID: WOS:000223440100017.
  2. Demir M, Kucuk L, Mermut G, Pullukcu H, Cavusoglu C, Isikgoz Tasbakan M. Tuberculous tenosynovitis in wrist flexor tendons. Tuberk Torak (2019) 67(3):236-8. doi: 10.5578/tt.68451. PubMed PMID: WOS:000493372200013.
  3. Bagir M, Sayit E. Tuberculous Tenosynovitis of the Wrist: A Report of Two Cases with Special Reference to Magnetic Resonance Findings. Curr Med Imaging (2019) 15(5):517-20. doi: 10.2174/1573405614666180919141141. PubMed PMID: WOS:000472025700012.
  4. Sbai MA, Benzarti S, Boussen M, Maalla R. Tuberculous flexor tenosynovitis of the hand. Int J Mycobact (2015) 4(4):347-9. doi: 10.1016/j.ijmyco.2015.06.003. PubMed PMID: WOS:000372921100015.
  5. Sonia R, Boussaid S, Abdelkafi I, Hela S, Ilhem C, Mohamed E. Osteoarticular Tuberculosis: A Retrospective Study of 119 Cases. Ann Rheum Dis (2017) 76:995-. doi: 10.1136/annrheumdis-2017-eular.6911. PubMed PMID: WOS:000413181403044.
  6. Brehm TT, Schmiedel S, Addo MM. Tuberculous Tenosynovitis. Dtsch Arztebl Int (2018) 115(42):714-. doi: 10.3238/arztebl.2018.0714a. PubMed PMID: WOS:000450975600008.
  7. Miladi S, Dhahri R, Hamdi W, Kaffel D, Abid L, Farah F, et al. Wrist synovectomy confirmed tuberculous tenosynovitis in 8 cases: A follow-up study. Egypt Rheumatol (2016) 38(3):257-61. doi: 10.1016/j.ejr.2016.02.004. PubMed PMID: WOS:000408670400019.
  8. Suwannaphisit S, Ranong NN. Tuberculous tenosynovitis of the Flexor Tendons of the hand and wrist: A case report and mini-review. Ann Med Surg (2020) 57:249-52. doi: 10.1016/j.amsu.2020.07.061. PubMed PMID: WOS:000570132300009.
  9. Mansour O, Moussa MK, Khalaf Z, Zreik H, Raad RB. Tuberculous Extensor Tenosynovitis Presenting as Huge Mass on the Dorsum of the Hand. Cureus (2020) 12(9). doi: ARTN e10236 10.7759/cureus.10236. PubMed PMID: WOS:000566019300002.
  10. Jira M, Qacif H, Sekkach Y, El Qatni M, Elouennass M, Ghafir D. Tuberculous tenosynovitis: an uncommon manifestation. Rev Med Interne (2007) 28(1):56-8. doi: 10.1016/j.revmed.2006.10.328. PubMed PMID: WOS:000243773000014.
  11. Jover-Saenz A, Porcel-Perez JM, Madronero-Vuelta AB, Gomez-Ribelles A. Tuberculous tenosynovitis in a patient with chronic corticosteroid therapy. Enferm Infec Micr Cl (2005) 23(6):391-2. doi: Doi 10.1157/13076187. PubMed PMID: WOS:000230385300016.
  12. Emmadi R, Lee J, Teopengko E. Tuberculous tenosynovitis: Identification and speciation from paraffin-embedded tissue. J Mol Diagn (2004) 6(2):152-. PubMed PMID: WOS:000221002500021.
  13. Chandrasekharan J, Sambandam SN, Cheriyakara S, Mounasamy V. Tuberculous tenosynovitis presenting as finger drop: a case report and a systematic review of the literature. Mltj-Muscle Ligament (2016) 6(2):258-63. doi: 10.11138/mltj/2016.6.2.258. PubMed PMID: WOS:000385696400015.
  14. Gokkus K, Sagtas E, Aydin AT. Tuberculous Tenosynovitis of the Wrist Mimicking a Volar Wrist Ganglion Cyst and Carpal Tunnel Syndrome. Turk J Rheumatol (2013) 28(2):128-31. doi: 10.5606/tjr.2013.2765. PubMed PMID: WOS:000320597200010.
  15. Walker UA, Gutfleisch J, Peter HH. Case number 23: Tuberculous tenosynovitis. Ann Rheum Dis (2002) 61(5):384-. doi: DOI 10.1136/ard.61.5.384. PubMed PMID: WOS:000175320600002.
  16. Esenyel CZ, Bulbul M, Kara AN. Isolated tuberculous tenosynovitis of the flexor tendon of the fourth finger of the hand - Case report. Scand J Plast Recons (2000) 34(3):283-5. PubMed PMID: WOS:000089274100017.
  17. Karunadasa KP, Dissanayake DA, Beneragama TS, Perera D. Staged flexor tendon reconstruction in a patient with caseous tuberculous tenosynovitis. J Hand Surg-Eur Vol (2010) 35e(6):515-6. doi: 10.1177/1753193409360604. PubMed PMID: WOS:000279760600019.
  18. Gupta L, Gupta V, Kumar T. Rice Bodies in Tuberculous Tenosynovitis of Wrist. Reumatol Clin (2018) 14(5):314-6. doi: 10.1016/j.reuma.2017.08.003. PubMed PMID: WOS:000444033400014.
  19. Samson M, Roch N, Audia S, Berthier S, Leguy V, Bonnotte B, et al. Tuberculous tenosynovitis. Presse Med (2011) 40(9):877-81. doi: 10.1016/j.lpm.2011.02.032. PubMed PMID: WOS:000295384800012.
  20. Amine B, Benbouazza K, Bahiri R, Hajjaj-Hassouni N. Multifocal tuberculous tenosynovitis. Joint Bone Spine (2006) 73(4):474-5. doi: 10.1016/j.jbspin.2005.08.002. PubMed PMID: WOS:000239745500026.

Cite this Article:

International Journal of Sciences is Open Access Journal.
This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Author(s) retain the copyrights of this article, though, publication rights are with Alkhaer Publications.

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